The choice of renal replacement therapy (RRT), including dialysis and transplant, must be made jointly between the patient and their renal healthcare team, as well as their family or carer, and if appropriate. The decision will be based on patient preference, life expectancy, existing co-morbidity and predicted quality of life. Patients and their families should be offered an educational programme tailored to their individual needs to enable patients to make an informed decision.

RRT considerations

All renal patients should be advised to follow a healthy, balanced diet. In particular, they should be advised to limit their intake of potassium as this can accumulate to dangerous levels in patients with end stage renal disease, increasing the risk of fatal cardiac arrhythmia. Dialysis patients should be encouraged to consume a good amount of protein in their diet. This is especially important for patients on PD as they are at increased risk of deficiency.